Ricky's Riffs:

Random Thoughts on Travel, Education, Health, and the World in General


Pain, the Opioid Crisis, and Alternative Care

November 19th, 2018

Drug overdoses killed approximately 72,000 people in in the United States in 2017. This was an increase of 10% from 2016. The two reasons cited are (1) Americans continue to use opioids in increasing numbers, and (2) there are more powerful, deadlier, synthetic opioids available in the underground marketplace—mainly fentanyl, which is 100 times stronger than morphine.  While the latter is the primary cause of fatalities, there is a connection between the two explanations.

It is established that of those who die of opioid overdoses, 80% started their use/abuse of these drugs with a prescription for pharmaceutical painkillers: for football injuries, work injuries, post-surgical pain, dental issues. Too many medical doctors prescribe these drugs routinely.Read the rest of this entry »


Interview: “A Rationale For a Single Payer Health Care System.”

November 9th, 2018

Ricky is interviewed by Michael Finney, consumer affairs reporter for Channel 7 Bay Area and KGO Radio, about his article “A Rationale For a Single Payer Health Care System.”


On the Opioid and Gun Violence Epidemics: Rationales in Common

September 19th, 2018

We are currently in the midst of the most lethal drug epidemic in our country’s history. One of the shocking things about this crisis is that it has been going on for the past 20 years without showing any signs of letting up.  In 2016, overdoses involving opioids killed more than 42,000 people.  Of those deaths, 40% were from prescription opioids.   (Statistics are still being finalized for 2017.)

Several recent books describe the evolution of this epidemic, each from a slightly different perspective.*  I’ll focus on just one of them here.Read the rest of this entry »


A Doctor Examines Trumpcare – Ricky’s recent Interview with Michael Finney

July 9th, 2017

Dr. Ricky Fishman talks about the current battle in Congress over Trumpcare, the unpopular bill being pushed by the Republican majority.  He describes the  effects of this bill on millions who may lose their health insurance and discusses where he sees health care going.  He believes that, in the end, we will have a single payer system.  However, the powers aligned against this movement are enormous.  Have a listen!


How the ACA is “Blowing Up” the Health Care System and Why That is a Good Thing

April 4th, 2017

The American Health Care Act (AHCA) was written, presented, lobbied for and rejected within the first 60 days of Donald Trump’s presidency. For eight years, the Republicans had made “repeal and replace Obamacare” their rallying cry.  Yet even with control of both the executive and legislative branches of the Congress, Republicans were unable to pass what was to be their “signature” piece of legislation. It died a messy death in the House of Representatives.

The rushed and poorly thought out bill was defeated by the Democrats as well as by the Freedom Caucus, the ultra-conservative wing of the Republican Party.

The bill’s defeat was a victory for the Democratic party, but also for America. The Affordable Care Act (ACA)—an important step on the path towards universal health care coverage for all Americans—was, for the time being, preserved.Read the rest of this entry »


Obamacare and the Shifting of the American Mind

March 20th, 2017

The first order of business for Donald Trump and the Republican party was to “repeal and replace” the Affordable Care Act (ACA), commonly known as Obamacare.

Obamacare was the signature piece of legislation of President Obama’s eight years in office.  In terms of historical significance, it has been compared to Social Security and Medicare. It was a big leap–and a messy one.Read the rest of this entry »


Trump Excitement Disorder (TED)…or Tribal Fever

March 7th, 2017

The shock of Donald Trump’s election has left many people disoriented.  Assumptions about the nature and order of the world have been upended.

Few, but not all, on the left side of the political spectrum believed Trump could be elected.  Yet here we are, six weeks into a Trump presidency.  He has moved with lightning speed, issuing executive orders at a dizzying pace, working diligently to undo the work of President Obama.

I described some of the effects of Trump’s election in my last piece “Trump Induced Stress Disorder: A New Diagnosis for a New Era”.  In that article, I described the physical and emotional effects on the millions of people who were aghast at his electoral victory.

But the Trump supporters are now displaying their own spectrum of signs and symptoms. I label their syndrome “Trump Excitement Disorder,” or TED.Read the rest of this entry »


Trump Induced Stress Disorder (TISD): A New Diagnosis for a New Era

January 3rd, 2017

On November 9, 2016 I was in my office, getting ready to see patients. It was the morning after Donald Trump had been elected President of the United States of America.

His election sent shock waves through the country and the world.

A dark cloud seemed to hang over my patients.  Most expressed disbelief that this person—one who ran a campaign of misogyny, racism and Islamophobia, who lied with impunity and who picked as his vice presidential running mate a hard core homophobe and creationist—could possibly win.  Yet he had.

The election of Donald Trump has no parallel in modern (or perhaps in all of) United States history. I have been trying to understand it. One way I have found is to think of Trump’s ascendance as an exotic virus that has entered our national bloodstream, infecting the body politic.  I call it “Trump Induced Stress Disorder,” or TISD.Read the rest of this entry »


Interview With Michael Finney–On the Direction of Health Care, 6/4/16

July 15th, 2016

Here is a radio interview I did with Michael Finney, KGO TV (Channel 7) consumer news reporter, on the direction I see health care moving in this country. We talked, among other things, about the differences, and similarities, between Bernie and Hillary on how we get to universal coverage. I explained to Michael how the changes in the health care system over the last several years have deeply impacted providers; about how most people have no idea about the reimbursement cuts most doctors have had to take; and more. So check it out and feel free to let me know your thoughts on this subject.

 


Revolution or Incrementalism: The Battle Over American Health Care

May 14th, 2016

As a health care provider, I have followed his year’s democratic presidential race with great interest. One major policy difference between Bernie Sanders and Hillary Clinton is that Bernie is pushing for a single payer model and Hillary wants to “build” on the Affordable Care Act that was passed under President Obama.

Here are a few of my thoughts on the subject.Read the rest of this entry »